NDARC Technical Report No. 19 (1993)
INTRODUCTION
The Readiness to Change Questionnaire (RCQ) is a 12-item instrument for measuring the "stage of change" reached by an excessive drinker of alcohol. It is based on the stages of change model developed by Prochaska and DiClementel which describes the stages through which a person moves in an attempt to resolve an addictive problem. From "Precontemplation" through "Contemplation" and "Action" to "Maintenance", the person is assumed to pass from one stage to the next, with the Relapser re-entering the cycle at either the Precontemplation or Contemplation stages. It may take many cycles around the stages of change before an addictive problem is finally solved.
The main attraction of the model is that it introduces the possibility of using different intervention strategies for clients at different stages of change. For example, focussing on the training of new self-management skills' might be a waste of time if the person has not yet reached the Action stage; relapse prevention techniques' are ideally suited to someone moving from Action to Maintenance; and motivational interviewine is best directed to someone in the Contemplation stage. All this assumes, however, that the stage a person has reached can be accurately assessed.
For a fuller account of the stages of change model and its implications for the treatment of addictive disorders, the reader is advised to consult the references given at the end of this manual. Suffice it to say here that in recent versions a Preparation stage, in between the Contemplation and Action stages, has been added to the model.
At the same time as there has been growing interest in the stages of change model, increasing attention has been paid to the use of brief interventions in the modification of addictive behaviours, particularly excessive drinkers with low levels of dependence on alcohol. These brief interventions have been mainly developed in health care settings, and are aimed at a goal of reduced or "responsible" drinking. They are sometimes called "opportunistic" because they attempt to identify excessive drinkers in situations where the individual has not attended specifically to complain of a problem with drinking and then use this opportunity to modify drinking behaviour.
The RCQ was developed to provide a short and convenient measure of the drinker's stage of change for use in conjunction with brief, opportunistic interventions with excessive drinkers in medical and other settings. It was deliberately designed to be quick and easy to administer and score to save time in the busy practices in which it would be used.
This revised version of the User's Manual takes account of recently published data on the predictive validity of the RCQ and describes two different methods, a "'Quick" and a "Refined" method, for deciding which stage of change a subject is in. Reference is also made to some as yet unpublished data relevant to the use of the RCQ in matching excessive drinkers to optimal types of brief intervention.